Causes of necrosis

Necrosis can occur due to aseptic and septic influences. Aseptic influences include mainly mechanical events, circulatory disorders, radiation damage, toxins, and thermal changes (e.g. frostbite). Circulatory disorders are caused, for example, by diabetes, smoking, alcohol consumption, genetic factors or the long-term use of medication.

Septic necrosis is caused by infections with pathogens such as bacteria, viruses and fungi. Each of these causes causes causes cell damage in an individual way. The cell reacts to the influencing factor and swells up.

The cell bursts and the cellular components are released. These trigger an inflammation in the surrounding tissue, which leads to the release of inflammation factors. This causes the tissue to swell and hurt.

The inflammation factors can also lead to the death of further cells, which increases necrosis. A decubitus is a poorly healing wound caused by immobility and inadequate positioning. A decubitus is often observed in bedridden patients.

These lie mainly on the back, which causes increased pressure, for example at the level of the coccyx. The persistent pressure leads to an undersupply of blood and thus oxygen to the area. The tissue becomes acidic and necroses develop.

Often a decubitus is not noticed in time and so-called ulcers (deep wounds) occur. The longer the pressure is applied to the decubitus, the larger the wound becomes in diameter and depth. Since a pressure ulcer heals very poorly, it is particularly important to turn bedridden patients in bed every few hours to achieve an optimal positioning.

In osteochondrosis dissecans, the death of joint-forming bone tissue occurs, which can lead to a detachment of the bone fragment and the adjacent joint cartilage. Osteochondrosis often occurs in children and adolescents and is probably caused by traumatic influences or sudden stress on the respective joint (e.g. through frequent jumping). The knee joint is most frequently affected, as it is usually the joint that is subjected to the greatest stress.The therapy of osteochondrosis dissecans depends on the age of the patient, the stage, the joint and the respective anatomical conditions.

In the case of iatrogenic (physician-induced) radiation, for example in tumor therapy, the ionizing radiation can cause so-called radiation necrosis or radionecrosis. However, one speaks of radiation necrosis in particular when these affect healthy tissue, since the death of the tumor tissue was intentional and therefore does not represent a complication. The ionizing radiation can cause damage to the DNA of the cells, causing them to die and necrosis to develop. It is important to note that such radionecrosis can occur very slowly, sometimes years after irradiation.